Article Text

Download PDFPDF
Review
Neuroendocrine tumours: what gastroenterologists need to know
  1. Mohid S Khan1,
  2. D Mark Pritchard2,3
  1. 1 Wales NET Service, Department of Gastroenterology, Cardiff and Vale University Health Board, Cardiff, Cardiff, UK
  2. 2 Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
  3. 3 ENETS Centre of Excellence, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
  1. Correspondence to Professor D Mark Pritchard, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool L69 3GE, UK; mark.pritchard{at}liverpool.ac.uk

Abstract

Gastroenterologists are intermittently involved in diagnosing and managing patients who have neuroendocrine tumours (NETs). However, few UK gastroenterologists have received extensive training about this topic. This article aims to provide a brief introduction to NETs; it is aimed at a general gastroenterologist audience.

NETs present in diverse ways and many symptomatic patients unfortunately experience significant delays in diagnosis. Comprehensive evaluation of a patient with a possible NET involves assessing their symptoms, the tumour’s primary organ of origin, its differentiation status, grade and stage, whether the NET is secreting hormones and whether there is any underlying hereditary predisposition. Such assessment often needs specialist investigations such as nuclear medicine scans. All these factors influence patient management and prognosis, so a patient’s case and investigations should always be discussed by a fully constituted NET multidisciplinary team. Most localised tumours are considered for resection, but there are multiple treatment options for metastatic disease and many patients receive several different therapies during the course of their illness. The most common first line treatment in patients who have metastatic low grade NETs is monthly long acting somatostatin analogue injections. Prognosis is highly variable, but some patients who have inoperable metastases survive for many years on treatment with good quality of life. Gastroenterologists may also be involved in managing the non-tumour associated chronic gastrointestinal problems that some patients experience. Their involvement has been shown to improve patient-reported outcomes and quality of life.

  • gastrointestinal neoplasia
  • gut hormones
  • gastrointestinal cancer
  • small bowel disease
View Full Text

Statistics from Altmetric.com

Footnotes

  • Twitter @DrMohidKhan, @gastrolivuni

  • Contributors MSK and DMP both wrote sections of the first draft of this review and both revised the final article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests DMP has received consultancy funding from Ipsen, Advanced Accelerator Applications and Mayoly Spindler laboratories and research funding to investigate gastric NETs from Trio Medicines. MSK has received consultancy and speaker fees from Ipsen,Advanced Accelerator Applications and Novartis.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.